Pediatrics, Parenting

Diaper Rash

HFFY#6458

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Diaper Rash
Diaper rash (diaper dermatitis) is one of the most common problems in babies. The diaper area,
tightly covered by plastic pants or plastic-covered diapers, is damp and warm. This encourages the
growth of bacteria and yeast, and increases irritation from urine and stool. It used to be thought that
ammonia in the urine was a cause of diaper rash, but research has shown that the concentration and
strength of ammonia in a baby's urine are the same in infants with or without diaper rash. The
wetness of urine and stool, as well as enzymes in stool are now thought to be the main causes.
The treatment of diaper rash works best if the reason for the diaper rash is found. The baby’s skin
may be more sensitive to irritants than that of older persons. In fact, exposure to urine or frequent
loose stools is the most common cause of diaper rash. Frequently, yeast (Candida albicans) may
grow in the diaper area. The use of oral antibiotics (for example for ear infections) may encourage
the overgrowth of yeast in the diaper area.
Sometimes, bacteria may overgrow in the diaper area and require antibiotic treatment. An allergic
reaction from a cream or ointment may also cause a rash.
The diaper area should always be kept as dry as possible. When changing the diaper after urination,
the area should be dried gently. Washing the area each time that the baby urinates may irritate the
skin, and is not needed. If baby wipes are not irritating, they may be used after each bowel
movement. If the baby wipes are irritating, plain water may be used to clean after the bowel
movement. A soap-free cleanser such as Aquanil
®
or Cetaphil
®
may also be used. Studies
comparing cloth diapers to plastic covered disposable diapers have demonstrated that the new thin
disposable diapers decrease the incidence of diaper rash.
Ointments, such as plain zinc oxide, Triple Paste
®
, Desitin
®
, Balmex
®
, or A and D Ointment
®
can
prevent the skin from coming in contact with irritants, such as diarrhea. Your doctor may prescribe a
mild corticosteroid salve to be applied to the affected areas if an irritant dermatitis is thought to be
present. Yeast infections are best treated by using a prescription anti-fungal salve for several weeks.
Many other inflammatory skin diseases or even systemic diseases can appear in the diaper area. If
the diaper rash does not respond to treatment, it is important to have your child checked by his or her
doctor. Sometimes special tests such as a skin biopsy may be needed to make clear the diagnosis.
UW Dermatology Department
1 S. Park St 7th Floor
Madison, WI 53715
Clinic: 608 287-2450
American Family Children’s Hospital
Pediatric Dermatology Specialty Clinic
1675 Highland Ave.
Madison, WI 53792
Clinic: 608 263-6420
Copyright  11/2012 University of Wisconsin Hospitals and Clinics Authority. All rights reserved. Produced by the
Department of Nursing HF#6458